Polysomnographic Outcomes After Observation for Mild Obstructive Sleep Apnea in Children Younger Than 3 Years.
Polysomnographic Outcomes After Observation for Mild Obstructive Sleep Apnea in Children Younger Than 3 Years.
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3岁以下儿童轻度阻塞性睡眠呼吸暂停的多导睡眠图观察结果
DOI：
10.1177/0194599820954383
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Ishman SL
中科院分区：
文献类型：
--
作者：
Sarber KM;von Allmen DC;Tikhtman R;Howard J;Simakajornboon N;Yu W;Smith DF;Ishman SL
轻度阻塞性睡眠呼吸暂停（OSA），特别是在幼儿中，通常采用观察治疗。然而，关于这种方法的结果几乎没有证据。我们的目的是评估观察对3岁以下轻度OSA患儿睡眠的影响。病例对照研究。儿科三级保健中心。我们回顾了2012年至2017年期间接受观察治疗的诊断为轻度OSA（阻塞性呼吸暂停-低通气指数，1-5事件/小时）的儿童（<3岁）病例，这些病例间隔3至12个月进行至少两次多导睡眠图检查。收集人口统计资料和合并症诊断。26名儿童符合纳入标准；中位年龄为7.2个月（95% CI, 1.2-22.8）。9名（35%）为女性，24名（92%）为白人。他们的身体质量指数中位数为39 （95% CI, 1-76）。合并症包括心脏病（42.3%）、喉软化（42.3%）、过敏（34.6%）、反应性气道疾病（23.1%）和早产（7.7%）。阻塞性呼吸暂停-低通气指数从2.7事件/小时（95% CI, 1-4.5）显著降低至1.3事件/小时（95% CI, 0-4.5; P = 0.013）。中位饱和最低点（基线，86%,P = 0.76）或中位潮末二氧化碳浓度为50 mm Hg的时间（基线，0分钟，P = 0.34）无显著改善。8例（31%）患者缓解，1例（3.8%）患者恶化。根据回归分析，只有种族是分辨率的显著预测因子；然而，只有2名非白人儿童被包括在内。在我们的队列中，经过3至12个月的观察，31%的患者出现了轻度OSA的缓解。喉软化、哮喘和过敏的存在不影响解决。需要更大规模的研究来更好地确定与持续性OSA相关的因素（包括种族）和这些儿童的最佳干预时机。
Mild obstructive sleep apnea (OSA), particularly in young children, is often treated with observation. However, there is little evidence regarding the outcomes with this approach. Our aim was to assess the impact of observation on sleep for children aged <3 years with mild OSA. Case-control study. Pediatric tertiary care center. We reviewed cases of children (<3 years old) diagnosed with mild OSA (obstructive apnea-hypopnea index, 1–5 events/h) who were treated with observation between 2012 and 2017 and had at least 2 polysomnograms performed 3 to 12 months apart. Demographic data and comorbid diagnoses were collected. Twenty-six children met inclusion criteria; their median age was 7.2 months (95% CI, 1.2–22.8). Nine (35%) were female and 24 (92%) were White. Their median body mass index percentile was 39 (95% CI, 1–76). Comorbidities included cardiac disease (42.3%), laryngomalacia (42.3%), allergies (34.6%), reactive airway disease (23.1%), and prematurity (7.7%). The obstructive apnea-hypopnea index significantly decreased from 2.7 events/h (95% CI, 1–4.5) to 1.3 (95% CI, 0–4.5; P = .013). There was no significant improvement in median saturation nadir (baseline, 86%; P = .76) or median time with end-tidal carbon dioxide >50 mm Hg (baseline, 0 minutes; P = .34). OSA resolved in 8 patients (31%) and worsened in 1 (3.8%). Only race was a significant predictor of resolution per regression analysis; however, only 2 non-White children were included. In our cohort, resolution of mild OSA occurred in 31% of patients treated with 3 to 12 months of observation. The presence of laryngomalacia, asthma, and allergies did not affect resolution. Larger studies are needed to better identify factors (including race) associated with persistent OSA and optimal timing of intervention for these children.
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影响因子：
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作者：
Chang, Sun Jung;Chae, Kyu Young
通讯作者：
Chae, Kyu Young
DOI：
10.1513/pats.200708-135mg
发表时间：
2008-02-15
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Lumeng, Julie C;Chervin, Ronald D
通讯作者：
Chervin, Ronald D
DOI：
10.3390/medsci5040030
发表时间：
2017-12-01
期刊：
Medical sciences (Basel, Switzerland)
影响因子：
--
作者：
Trosman, Irina;Trosman, Samuel J
通讯作者：
Trosman, Samuel J
影响因子：
3.1
作者：
Ramgopal, Sriram;Kothare, Sanjeev V.;Khatwa, Umakanth
通讯作者：
Khatwa, Umakanth
影响因子：
10
作者：
Li, A. M.;Au, C. T.;Wing, Y. K.
通讯作者：
Wing, Y. K.